According to Dr Nontobeko Sonjica, an emergency medical practitioner at Netcare St Anne’s Hospital, it is not unusual for emergency medical services personnel to attend to patients who have suffered dehydration, hyperthermia, heatstroke or heat exhaustion during the hot summer months.
“Given the current heat wave experienced in many parts of the country, it is important to exercise due caution when outdoors,” says Dr Sonjica. “On Thursday temperatures in Pietermaritzburg measured in the mid-forties and it was also extremely humid. As a result we saw quite a few patients who needed emergency care due to heat exhaustion and medical conditions which were exacerbated by the excessive heat. In weather such as this, parents of young children and the elderly should be particularly vigilant, especially those suffering from medical conditions such as epilepsy and hypertension or high-blood pressure, as it is commonly known.”
“Some people have to walk long distances or work outdoors, while others undertakevigorous exercise at the hottest time of the day, often underestimating thepower of the sun. They further increase their health risk by not staying properly hydrated. In hot conditions such as these, people should try to drink at least two litres of water a day,” advises Dr Sonjica.
Dangers of high temperatures
Dr Anchen Laubscher, Medical Director of Netcare and Netcare 911, explains that heatstroke occurs when the human body’s core temperature increases beyond 40 degrees Celsius. It can be fatal if not treated properly and promptly, she warns. Heatstroke can cause an individual to slip into a coma and suffer organ failure.
Heat generated by the body is usually dissipated by radiation via the skin or through the evaporation of sweat on the skin. Dr Laubscher notes that in extremely hot or humid environments and in cases where people overexert themselves, the body may not be able to dissipate the heat fast enough and an individual may suffer hyperthermia, which is simply an abnormally elevated body temperature. Dehydration may be another cause of hyperthermia.
“Heat exhaustion and heatstroke are forms of hyperthermia,” she points out. “Sometimes an individual will suffer from heat exhaustion which progresses to heatstroke. This is a more serious condition, if the body temperature isn’t lowered. Some individuals may develop heatstroke rapidly and without warning.”
Athletes, the young, the elderly, persons taking certain medications and outdoor workers may be particularly at risk of developing heatstroke, she observes. The condition can also be a threat to those undertaking vigorous work in warm indoor environments.
Helping someone with heatstroke
Dr Laubscher says it is vital to bring the heatstroke patient’s body temperature down to ensure that they do not suffer organ damage. First move the individual out of the sun and into the shade. You can remove as much as possible of their clothing and place them in a bathtub filled with cool or tepid water if they are conscious. Do not use ice cold water. Be sure to keep a close eye on them if you use a bath to make sure they do not lose consciousness.
Alternatively the patient may be hosed with cool water from a garden hose or sponged using a cool, wet cloth. They may be fanned to encourage evaporation on and cooling of the skin. It is also vital to hydrate the person by getting him or her to drink water or, even better, isotonic drinks containing electrolytes. If the patient cannot take any liquids orally, intravenous hydration by means of a drip is necessary.
Dr Heinrich Koekemoer, Senior Medical Officer at Netcare 911 says that signs and symptoms of heat exhaustion include nausea, headache, vomiting, fatigue, dizziness, muscle cramps and aches. The symptoms of heatstroke may differ from person to person and depend upon the cause thereof, but may also include those for heat exhaustion together with high body temperature, dry flushed skin with an absence of sweating, rapid pulse, trouble breathing, bewilderment and confusion, unusual and sometimes aggressive behaviour, seizure and coma. If any of these symptoms are noted it is advisable to seek medical assistance as soon as possible.
Dr Koekemoer offers the following important tips to members of the public to assist in coping with the current high temperature:
Try to avoid any strenuous physical activity in the heat or in hot, humid conditions.
Avoid exposure to the sun in the middle of the day, when UV intensity is at its greatest.
Make sure that you stay hydrated by drinking sufficient fluids such as water and sports drinks. However, do not overdo your drinking, as it is also possible to over-hydrate. You should not feel bloated after drinking fluids. Drink small amounts at regular intervals.
Avoid drinks that may dehydrate you further such as alcohol, fizzy colas, tea and coffee.
Wear wrap-around UV protective sunglasses and a wide-brimmed sun hat.
Apply a broad-spectrum sunscreen of sun protection factor (SPF) 15+ or more, liberally on areas of the body not protected by clothing. Reapply frequently.
Take care to ensure that babies and children are kept cool.
Avoid exposure to the sun during pregnancy.
Avoid excessive exposure to the sun whilst in swimming or engaging in other water related activities.
Check that medication taken will not affect your sensitivity to heat.
“Should you plan your activities with care and pay due respect to the sun, you could enjoy a summer without healthcare problems related to excessive heat,” concludes Dr Koekemoer.
(Press release, January 2013)
Coping with heat emergencies and hypothermia